Dr Duarte is presently affiliated with the Veterinary Teaching Hospital of CREUPI, Espirito Santo do Pinhal, SP, Brazil. Preliminary findings of this work were presented at the 18th American College of Veterinary Internal Medicine Forum, Seattle, WA, May 2000.
Accuracy of Serum β-Hydroxybutyrate Measurements for the Diagnosis of Diabetic Ketoacidosis in 116 Dogs
Article first published online: 28 JUN 2008
Journal of Veterinary Internal Medicine
Volume 16, Issue 4, pages 411–417, July 2002
How to Cite
Duarte, R., Simoes, D. M.N., Franchini, M. L., Marquezi, M. L., Ikesaki, J. H. and Kogika, M. M. (2002), Accuracy of Serum β-Hydroxybutyrate Measurements for the Diagnosis of Diabetic Ketoacidosis in 116 Dogs. Journal of Veterinary Internal Medicine, 16: 411–417. doi: 10.1111/j.1939-1676.2002.tb01258.x
- Issue published online: 28 JUN 2008
- Article first published online: 28 JUN 2008
- Revised September 24, 2001 and January 2, 2002; Accepted February 4, 2002
- Diabetes mellitus;
- Ketone bodies;
- Receiver operating characteristic analysis
The aim of this study was to evaluate the accuracy of serum β-hydroxybutyrate (β-OHB) measurements for the diagnosis of diabetic ketoacidosis (DKA) in dogs. One hundred sixteen diabetic dogs were prospectively enrolled in the study: 18 insulin-treated (IT) diabetic dogs that had a positive urine ketone test and 88 untreated, newly diagnosed diabetic dogs. Venous blood gas tensions and pH, serum glucose and urea nitrogen (SUN), and electrolyte (Na+, Cl-, and K+) and urine acetoacetate (AA) concentrations were measured concurrently with serum β-OHB concentrations. On the basis of laboratory findings, the patients were assigned to 1 of 3 groups: diabetic ketoacidosis (n = 43); diabetic ketosis (DK, n = 41); and nonketotic diabetes (NDK, n = 31). Serum β-OHB concentrations differed significantly (P < .001) among the study groups. Although marked differences in β-OHB concentrations were found, a considerable overlap exists between the distributions of dogs with DK and those with DKA. The overall accuracy of β-OHB determination as a diagnostic test for DKA, determined by the area under the receiver operating characteristic (ROC) curve, was 0.92. In the 1.9- to 4.8-mmol/L range, serum β-OHB determination sensitivity varied from 100 to 35.7%, whereas specificity varied from 39 to 100%. The cutoff value of 3.8 mmol/L showed the best equilibrium between specificity (95%), sensitivity (72%), and likelihood ratio (14.8). We concluded that the quantitative measurement of serum β-OHB may be a potential tool for diagnosing and monitoring ketosis and ketoacidosis in diabetic dogs.